Pramatya Stephen Hilkia, Al Fauzi Asra, Humairah Ira, Wungu Citrawati Dyah Kencono, Sastri Dija Melati, Dhuha Hasya Nur Ahmad Fuady
Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr. Soetomo Academic General Hospital, Surabaya, Indonesia.
Neurosurg Rev. 2025 Jun 6;48(1):487. doi: 10.1007/s10143-025-03639-2.
Stroke is the second leading cause of death globally. Intracranial hemorrhage is the most destructive type, with the thalamus being the location that has the worst prognosis. A meta-analysis of minimally invasive surgery in intracranial hemorrhage patients has been carried out previously and resulted in an improved prognosis. However, the efficacy and safety of minimally invasive surgery procedures remain subjects of debate. A comprehensive search was conducted in major databases such as PubMed, Scopus, Web of Science, Sage, Taylor and Francis, and Preprints in August 2024. From the search results, 2798 articles were obtained and then selected into ten articles. A risk ratio analysis was performed to compare the prognosis of minimally invasive surgery with conventional procedures. Risk ratios and 95% confidence intervals for minimally invasive surgery compared with conventional procedures in clinical trials and observational studies were 0.68 [0.55-0.84] and 0.57 [0.46-0.71], respectively. This meta-analysis also demonstrated that there was a significant reduction in the risk of death and the length of hospital stay in minimally invasive surgery patients. Nevertheless, there was no difference in the risk of rebleeding when compared with conventional procedures in patients with hemorrhagic stroke localized to the thalamus.
中风是全球第二大致死原因。颅内出血是最具破坏性的类型，丘脑是预后最差的部位。此前已对颅内出血患者的微创手术进行了一项荟萃分析，结果显示预后有所改善。然而，微创手术的疗效和安全性仍是争议话题。2024年8月，我们在PubMed、Scopus、Web of Science、Sage、Taylor and Francis以及预印本等主要数据库中进行了全面检索。从检索结果中，共获取2798篇文章，然后筛选出10篇文章。进行风险比分析以比较微创手术与传统手术的预后。在临床试验和观察性研究中，微创手术与传统手术相比的风险比及95%置信区间分别为0.68 [0.55 - 0.84]和0.57 [0.46 - 0.71]。该荟萃分析还表明，微创手术患者的死亡风险和住院时间显著降低。然而，对于丘脑局部出血性中风患者，与传统手术相比，再出血风险并无差异。
